What is the step-by-step procedure for performing transplantation wiring in a parasagittal split?

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Clarification Required: Question Appears to Address Maxillofacial Surgery, Not Transplantation

The term "transplantation wiring in parasagittal split" does not correspond to any established transplantation procedure in the provided evidence or standard medical literature. Based on the available evidence, this question likely refers to one of two distinct surgical contexts:

Most Likely Interpretation: Maxillofacial Surgery

The question most likely refers to fixation techniques following parasagittal osteotomy for maxillary transverse deficiency correction, not organ transplantation. 1

Parasagittal Split in Maxillofacial Context

  • Parasagittal osteotomy with Le Fort I is performed to correct maxillary transverse deficiency, representing one of the most common occlusal discrepancies 1
  • Fixation after parasagittal split typically involves plate and screw fixation rather than traditional "wiring" techniques 1
  • Early transverse relapse can occur after this procedure, potentially requiring salvage therapy with rapid maxillary expansion (RME) and removal of fixative plates on the constricted side 1

Key Technical Considerations

  • The procedure involves splitting the maxilla in a parasagittal plane during Le Fort I osteotomy 1
  • Modern fixation uses rigid internal fixation (plates/screws) rather than wire osteosynthesis 1
  • If relapse occurs, RME application may serve as appropriate salvage therapy 1

Alternative Interpretation: Neurosurgical Context

If referring to parasagittal meningioma surgery, "wiring" would not be the appropriate term, as vascular reconstruction uses autogenous vein grafts for sagittal sinus repair 2

Evidence Gap

The provided transplantation literature 3, 4, 5, 6 addresses liver transplantation techniques including split liver procedures, but contains no information about "transplantation wiring" or parasagittal splits in the transplantation context. These are fundamentally different surgical domains.

Recommendation for Clarification

Please specify whether you are asking about:

  1. Maxillofacial surgery: Fixation techniques after parasagittal osteotomy with Le Fort I
  2. Neurosurgery: Parasagittal meningioma resection techniques
  3. Another surgical specialty: Please provide additional context

Without clarification, a step-by-step guide cannot be accurately provided, as the terminology does not match established transplantation procedures in the available evidence.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Vascular Division Techniques in Minimally Invasive Living Donor Hepatectomy

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Living Liver Donor Evaluation

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Research

Split liver transplantation: past, present and future.

Pediatric transplantation, 2004

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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